Hello Good morning to all,

I herewith attaching my Moms Two Scan reports. The first one is taken on 20/11/2014 which I had already show you earlier. The second one is the new taken on 16-01-2015. Looking the latest result Dr. said that my Mom's condition is better now. The fluid decreased and continue the same madicine in small Dose 2 weeks also. After that dicide for the Hep C Treatment. But I am confused if the treatment delayed the infection is increased? Pls compare these two results and said me about her condition now. Is it Best or Worse compared to the earlier result?

Hi Saranya,

Interloop ascites is a very old term. It used to be used for abdominal tuberculosis. It just means fluid in the mesentery of the small intestine. Any case of severe ascites can have fluid in the mesentery.

This fluid can't be drained as it's trapped. As Jill said, diuretic tablets can help. The ascites is just part of your mother's liver failure.

Hello Saranya,

I`ll try to answer your question as best I can, but bear in mind that I`m not a doctor.  Ascites means an accumulation of fluid in the abdomen and it`s usually a symptom of cirrhosis of the liver.  I`m not too familiar with what interloop ascites are, but as I understand it they are pockets of fluid trapped in the membrane surrounding the small bowel. 

Ascites can be treated with diuretic tablets, such as the Lasilactone that your mother has been taking, or the fluid can be drained off by a needle being inserted.  These are short term measures though as the fluid will continue to build up.

I hope that is some help, although you really need to talk about this with your mother`s doctor now she has had her stomach scanned, and discuss what will be the best way forward.

Please keep in touch and let us know what her doctor says, and I wish you both the best of luck.

Best wishes!  Jill

Hello to All,

Pls anyone tell me what is interloop ascetis?

Hello again Saranya,

Good to hear that your mother`s stomach troubles have cleared up since she`s been on the medication, that must be so much more comfortable for her. 

I hope you and your mother will have more information about her health and treatment after her appointment and scan on Thursday, I hope it goes well. Try not to worry, just take it step at a time until you know more.  Do let us know the results.

Best of luck to you both!

Dear All, 

Next check up dat efor my mom is 15th january 2014. Now the dr. said that there is more fluid in her stomach and continuing the Lasilactone Tablet and on 15th January their will be a scaning of stomach. Now she loss her wait. The swollen stomach became very small. She have no discomfort now and look like a normal woman. Now she not feeling any stomach pain, gas problems, no vomiting etc. But thinking about the liver I am nervous. Now I hope for the new medicine( Sofosbuvir) Pls share your experience if any one in this condition have any symptoms??

Wishing you and your mother all the best of luck, Saranya, do keep in touch and let us know what happens after you`ve discussed all this with her doctor. 

We`ll be here to try and advise and answer any more questions you may have. 

Thanks to all who helps me by answering my questions, I will also need your valuable suggestions in future. Thanks............ and best wishes 

Hi again Saranya,

When the liver is contracted, scarred and irregular, it usually does not regenerate to any degree. If the cirrhosis is due to HepC, the new drug Sofosbuvir (Sovaldi) will soon be available in India. Companies like Cipla will be able to manufacture this at about $1,000.00 per 12 week course. The Genotype test should be repeated as the treatment depends on the Genotype.

I agree with Duane that Interferon should not be used.

You need to talk to your mother's doctor about what we've discussed. Best wishes.

I agree, interferon tx in that condition would be perilous, the only way I know of to help the liver recover somewhat, is to eliminate the current cause of the continuing destruction. I am sorry that you do not have access to the all oral medications which is the only safe way to rid her of the Hepatitis without damaging the liver further, but that and transplant are the only modes of improving the situation I am aware of.

I will pray that God provides a solution to your mothers dilemma, I know how hard this is for you and how helpless you may feel, but put your faith in God and all things will be resolved through his grace. 

Best wishes and prayers to your Mother and you...... you are a truly wonderful soul to be so helpful and concerned about her and I pray that peace will find it's way to your family.

Duane

I have one doubt also, First Doctor suggest to start interferon therapy, but now he hold it and said to wait for 1 month with another tablets. In this condition interferon therapy is not poiisble? Rather than liver transplantation any medication available to recover her condition from Decompensated Cirrhosis to compensated Cirrhosis. Liver transplantation is not a possible situation now, because of the unavailability of donor and we can't afford the cost of it.................. :(

All you need is the INR blood test results to calculate the MELD score, then go here http://www.mayoclinic.org/medical-professionals/model-end-stage-liver-disease/meld-model-unos-modification and it will calculate it for you.

You already have the Total  Billirubin and Creatinine so if you have the INR...... which I'm guessing you do, as it would be a pretty standard part of a work up for someone with the rest of the known results to have.

You can get a pretty good idea of the condition of the liver, I would agree with Mallani that it appears to be decompensated cirrhosis  and I'll guess that the INR comes in between 1.7 and 2.0 based on the other results and will yield a score of between 16-18  which is significant damage but not immediate day to day danger at this time.

If the patient is treated to successfully treat and cure the HEP C  or B or any other contributing factors,there is the possibility of going from decompensated to compensated with proper diet and professional care. 

However your Mother should most definitely be worked up for a pre transplant assessment with that level of liver disease, because in any case even though there maybe some improvement the likely hood of other complications is high and I don't  want to scare you with those.

If it helps calm your nerves.... I have decompensated cirhosiss meld scores from 14 -17 prior to HCC and have had very similar blood results as your mother, and I have been on the transplant list for over 2 yrs now, having successfully been treated and gone SVR from HEP c there has been dramatic improvements in liver function, so treating the underlying cause is the 1st order of business and will improve the quality of life a lot....but you must seriously consider the road to transplant if possible for long term best outcome.

I'm sorry if any of this has scared you, as it was not my intention but rather share my experience of the road ahead with truth.

God Bless,

Duane

Hi Saranya,

The test results are typical for cirrhosis. The bilirubin is elevated, The AST (SGOT) and ALT(SGPT) are elevated and there is reversal of the normal ratio. The AST/ALT ratio is >1 which is common in cirrhosis. The albumin is at the lower range of normal. The glucose is raised, suggesting some Insulin Resistance or diabetes. Your mother has decompensated cirrhosis.

You really need to discuss this with your doctor. The cause of the cirrhosis is not that important now. Jill (Cinnamon Girl) has provided you with a list of possible causes. It is up to your doctor to decide the cause, but it is probably due to HepC. You may need to discuss doing a MELD score, with a possible view to liver transplant. Any treatment is up to him.

You are fortunate to live in Kerala, which has excellent medical care. I have visited the Amrita Hospital in Kochi, and was impressed by their Radiology Department, and they also have an excellent record in liver transplantation.

Sorry to hear your problems. Best of luck.

Dear Mallani,

Good afternoon, As you asked, here I am attaching the albumin and Bilirubin test results. Pls go through it and give me solutions.

Hi Saranya,

You are doing a great job of taking care of your mom. I know this is a sad and scary time but you will get through it. I am thinking of you, sending good energy your way, and hoping for health and healing for your mom and peace of mind and heart for you.

Take care,

Rudi

Hello Saranya, welcome to the forum.

You must be very worried about your mother, and I feel for you in your distress.

If your mother was also infected with Hep B that could certainly cause liver damage and cirrhosis and I would say it would be a good idea for her to be tested for that too.  The surgery she had could not cause cirrhosis though and that won`t be the reason.

Here is some information about cirrhosis and the possible causes.  As you can see there could be many reasons for your mother`s health problems... 

http://www.niddk.nih.gov/health-information/health-topics/liver-disease/cirrhosis/Pages/ez.aspx

As Malcolm has said, the best course of action is for your mother to consult an experienced liver specialist or hepatologist who will be able to answer your questions more fully.

Wishing you both the best of luck!  ~ Jill

Dear Mallani,

The LFT results are not available with me now. I will send it latter. Pls siad me about the other reasons for Liver Cirrohsis. Now Dr. asked us to test for HBV. Is any chance for HBV Positive? Have any fault in surgeries causes liver cirosis? She had uteres removed before 8 years.

Hi Saranya,

Thanks for the results. You haven't posted the albumin , ALT or bilirubin. These will probably be under 'LFT's'.

Your mother has cirrhosis, which is probably long-standing, and she has portal hypertension, with oesophageal varices and ascites.

I see the Genotype test was done in Mumbai. There may have been a problem with the specimen, or the Viral Load may be too low for them to do a Genotype with their equipment.

Whether your mother's cirrhosis is due to HepC is uncertain. What does your doctor think?

There are many causes of cirrhosis. Cheers.

Dear Mallani,

Our Doctor Suggest a genotype test, and the result is attached. other results like albumin, Platelet etc are attached. Platelet count is low for her. We admitted her to hospital at a condition when one of her touth fall and the bleeding not stopped, at that time platelet count is only 66000, and then many tests conducted and finally confirmed she have HCV, Now the count is 77000, All results attached.The ANA shows a negative result Now the gastro entrologist saggest that no medicine sitable for her present condition is available in India. Is this cirhossis is due to other reason? We are so much confused and sad....

Hi Saranya,

The Ultrasound shows your mother has liver cirrhosis. Do you have other results of blood tests, such as platelet count, albumin, ALT and bilirubin?

The Hepatitis test is rather confusing. The PCR-Quantitative result shows a Viral Load of only 1683 i.u./ml which is very low. I am not sure why the Lab in Trivandrum could not do a Genotype test on this.

Your mother should see a liver specialist (Hepatologist) to fully assess her liver. Whether the cirrhosis is due to HepC is uncertain at this point. Try to get some more information. Cheers.